Ovarian hyperstimulation complicating the clinical presentation of a pre-existing ectopic pregnancy

1988 ◽  
Vol 50 (4) ◽  
pp. 670-671 ◽  
Author(s):  
Richard J. Paulson ◽  
Rogerio A. Lobo
Author(s):  
Meetali Parashar ◽  
Meena Mehta

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.


Author(s):  
Meenakshi T. Chate ◽  
Bhagyashree Chate ◽  
Kranti Chate

Background: Ectopic pregnancy is pregnancy that develops following implantation anywhere other than the endometrial cavity of uterus. Objective of present study was to investigate the risk factors, clinical presentation and sites of ectopic pregnancy along with management and assessment of risk of maternal mortality and morbidity.Methods: The study was undertaken at Dr. Shankar Rao Chavhan Government Medical College and Guru Govind singhji hospital, Nanded between December 2012 and May 2014 after obtaining clearance from the Hospital Ethical Committee.Results: Maximum incidence of tubal gestation occurred between the age group of 21-25 years. Greater incidence was noted in multiparous woman. Tubectomy was the most common risk factor seen in 23.65% cases. The most common symptom observed is abdominal pain seen in 92.47% cases. The most common site of ectopic was ampulla seen in 51.61% cases. The most common mode of presentation was rupture seen in 71 cases about 76.35% cases. Unilateral salpingectomy was done in 70 cases about 75.26% cases.Conclusions: Since ectopic pregnancy remains a gynecological catastrophe in countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue. With its rising incidence, which is likely to continue increasing because of the various factors discussed, it is necessary to devise means of early detection and treatment.


2021 ◽  
Vol 15 (10) ◽  
pp. 2845-2847
Author(s):  
Areeba Aftab ◽  
Memoona Faiyaz ◽  
Uzma Fahim ◽  
Humaira Tabassum ◽  
Saima Rafique ◽  
...  

Objective: To adjudge the prevalence of distinct presentations in ectopic pregnancy. Research Design: Descriptive cross-sectional. Place and Duration of Study: Emergency Labour Ward Department of Obstetrics & Gynecology, Nishtar Hospital Multan from 1.07.2017 to 31.12.2017. Methodology: Ninety five patients having positive pregnancy tests and uterine cavity with no intrauterine gestational sac on ultrasound were included. Clinical presentation like amenorrhea, vaginal bleeding, acute abdomen, shock or asymptomatic were assessed. Results: Amenorrhea observed in 73(76.8%) women, vaginal bleeding was seen in 32 (33.7%) women, 88 (92.6%) patients presented with acute abdomen and vitals instability was seen in 8 (8.4%) patients and 6(6.3%) patients were without symptoms. Conclusion: The two most common clinical presentations in patients included in study were amenorrhea and acute abdomen. Thorough evaluation of the patients with sub-acute or chronic presentation should be adopted to diagnose the cases of ectopic pregnancy. Key words: Ectopic pregnancy; Clinical presentation; Variations


Author(s):  
Indu Verma ◽  
Punya Priya ◽  
Charvi Chugh ◽  
Harsharan Kaur ◽  
Dinesh Sood

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.


Author(s):  
Kavitha Garikapati ◽  
M. Parvathi Devi ◽  
N. Alekya Goud

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.


2018 ◽  
Vol 34 (1) ◽  
pp. 174-178
Author(s):  
Kaho Suzuki ◽  
Yasuhiko Ebina ◽  
Satoshi Nagamata ◽  
Tokuro Shirakawa ◽  
Hitomi Imafuku ◽  
...  

2018 ◽  
Vol 4 (2) ◽  
pp. 146-149
Author(s):  
Nethra H S ◽  
Praneetha K ◽  
Sreelatha S ◽  
Seema Shyam Bhairi

Author(s):  
Prativa Sadangi ◽  
Kumari Ranjeeta ◽  
Manasi Jena

Clinical presentation of chronic ectopic pregnancy is often vague and confusing. Because of this diagnosis becomes delayed and difficult. Here we present one such case, reporting to our hospital. The low resource set up led to limitations in our approach and here we point out the factors which led to the diagnostic dilemma. We are reporting this case because similar challenges can be faced by other clinician in our field.


Author(s):  
Ayman Al-Talib

Caesarean scar ectopic pregnancy (CSEP) is an uncommon form of ectopic pregnancy. This review defines types of CSEP, discusses pathophysiology, clinical presentation and diagnosis and compares common treatment options and outcomes. The pathophysiology is not yet fully understood. One third of patient are asymptomatic. In symptomatic patients vaginal bleeding and pelvic pain which is usually misdiagnosed as threatened or missed abortion. The main principles of treatment for CSEP are early diagnose, quick management, and maintain reproductive function as much as possible. Up to date; no consensus or guidelines for the treatment and management of CSEP. Management of CSEP depends on the clinical presentation and gestational age. Significant controversy exists regarding management, for this reason, several factors should be considered including age of the patient, myometrial thickness, clinical symptoms, hemodynamic status, fertility preservation.


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